# JOHN COSGROVE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1467996207
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 246Z00000X | Other Specialist/Technologist | 2000017672 | NY | Yes |
| 363A00000X | Physician Assistant | 2000017672 | MI | Yes |
| 363A00000X | Physician Assistant | 5601014208 | MI | Yes |

## Other

- **Enumeration date:** 12/13/2016
- **Last updated:** 09/07/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2000017672 | ATC | NY |